Provider Demographics
NPI:1881897064
Name:MEROLA, MARY ANN (RN)
Entity type:Individual
Prefix:
First Name:MARY ANN
Middle Name:
Last Name:MEROLA
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 S.E. 1ST AVENUE
Mailing Address - Street 2:
Mailing Address - City:POMPANO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33060
Mailing Address - Country:US
Mailing Address - Phone:954-786-1883
Mailing Address - Fax:
Practice Address - Street 1:3275 NW 99TH WAY
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33065-4024
Practice Address - Country:US
Practice Address - Phone:954-341-3925
Practice Address - Fax:954-341-3919
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN 2597072163W00000X, 163WA0400X, 163WR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Not Answered163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)
Not Answered163WR0400XNursing Service ProvidersRegistered NurseRehabilitation